Limjoco Jamie, Paquette Lisa, Ramanathan Rangasamy, Seri Istvan, Friedlich Philippe
1Department of Pediatrics, Division of Neonatology, Meriter Hospital, University of Wisconsin School of Medicine and Public Health, Madison, WI 2Department of Pediatrics, USC Division of Neonatal Medicine and the Center for Fetal and Neonatal Medicine, Children's Hospital Los Angeles and LAC + USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Am J Ther. 2015 Mar-Apr;22(2):125-31. doi: 10.1097/MJT.0b013e31826fc4ec.
The aim of this study was to evaluate changes in mean blood pressure (MBP) in late preterm and term newborns with meconium aspiration syndrome (MAS) or sepsis who, in addition to inhaled nitric oxide (iNO), received enteral sildenafil for treatment of persistent pulmonary hypertension of the newborn. Data on sildenafil dosing, MBP, and vasopressor/inotrope use were collected for 72 hours after initiation of sildenafil. Groups were compared between "low dose" (<3 mg·kg·d) versus "high dose" (≥ 3 mg·kg·d) and "early" (<7 postnatal days) versus "late" (≥ 7 postnatal days) administration of sildenafil. Seventeen patients were identified. Ten and 7 patients received "low-dose" and "high-dose" sildenafil, respectively, and 8 and 9 patients were started on sildenafil "early" and "late," respectively. At the doses used, sildenafil treatment of infants with MAS and sepsis was not associated with changes in MBP. In addition, vasopressor/inotropic support was weaned in all groups. During the first 72 hours of enteral sildenafil administration in neonates with pulmonary hypertension of the newborn secondary to MAS or sepsis, no significant decrease in MBP or increase in vasopressor/inotrope requirement occurred.
本研究的目的是评估患有胎粪吸入综合征（MAS）或败血症的晚期早产儿和足月儿在吸入一氧化氮（iNO）基础上接受肠内西地那非治疗新生儿持续性肺动脉高压时平均血压（MBP）的变化。在开始使用西地那非后72小时收集西地那非剂量、MBP以及血管升压药/正性肌力药物使用的数据。比较“低剂量”（<3mg·kg·d）与“高剂量”（≥3mg·kg·d）以及西地那非“早期”（出生后<7天）与“晚期”（≥7天）给药的组间差异。共纳入17例患者。分别有10例和7例患者接受“低剂量”和“高剂量”西地那非治疗，分别有8例和9例患者“早期”和“晚期”开始使用西地那非。在所使用的剂量下，西地那非治疗MAS和败血症婴儿与MBP变化无关。此外，所有组的血管升压药/正性肌力药物支持均逐渐减少。在因MAS或败血症继发新生儿肺动脉高压的新生儿肠内给予西地那非的最初72小时内，MBP无显著下降，血管升压药/正性肌力药物需求也未增加。
